Attachment B_Form-10-352-Identification-and-Credit-Information-Individual.docx
DOCX document 636 KB Posted
- Attached to
- Request For Proposals to Lease the RV Park and Campground at Fort Monroe National Monument
- Solicitation number
- FOMR_RFP_RV_PARK_AND_CAMPGROUND_RFP_2025
About this file
This document is a Request for Proposals (RFP) issued by the National Park Service (NPS) for leasing the RV Park and Campground at Fort Monroe National Monument in Hampton, Virginia. The 13-acre property includes Building 32, multiple shelters, tennis courts, 23 camping sites with various utility hookups, and a 150-space parking area. The lease opportunity seeks a qualified operator to manage the RV park and campground, with potential for hosting small-scale events at Shelter 5 (maximum 200 people capacity).
Key terms include a lease term of up to 10 years, with rent structured as 10% of gross revenue (Fair Market Value Rent), required insurance coverage of $2 million for property and $2-4 million for general liability, and full maintenance responsibilities for the lessee. The RFP was released on April 2, 2025, with initial proposal submissions due by June 6, 2025. Proposals will be evaluated on criteria including compatibility with park values, historic preservation, financial capability, operational experience, environmental enhancement, and financial terms offered. The NPS reserves the right to reject any or all proposals and negotiate final lease terms with the selected offeror.
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Text version
| NPS Form 10-352 (07/2020) | OMB Control No. 1024-0233 | |
| National Park Service | Expiration Date: 10/31/2024 | |
| NPS Form 10-352 (07/2020) | OMB Control No. 1024-0233 | |
| National Park Service | Expiration Date: 10/31/2024 | |
| IDENTIFICATION AND CREDIT INFORMATION (INDIVIDUAL) |
| NPS Leasing Program |
| Commercial Services Division |
| 1849 C Street, NW |
| Washington, DC 20240 |
I. IDENTIFICATION INFORMATION
| Name |
| Telephone Number |
| Alternate Number |
| Email Address |
| |_| Cell |
|_| Fax
| Address |
| City |
| State |
| Zip Code |
| Education |
| Degrees |
| Licenses |
| Designations |
| Special Skills |
| Name of Current Employer |
| Title of Position Most Recently Held |
| Nature of Business |
| Dates of Employment |
| Address of Employment |
| City |
| State |
| Zip Code |
Description of Duties and Responsibilities (Include number of people supervised)
| Proposed Role in Lease Operations |
| Qualifications for that Role |
| Estimated Time per Week Dedicated to Role |
II. CREDIT INFORMATION
1. List any Foreclosures, Bankruptcies, Transfers in Lieu of Foreclosure and/or Work-Out/Loan Modification Transactions during the past 10 years. (If none, so indicate). Attach an explanation of circumstances, including resolution, bankruptcy plan, and/or other documentation as appropriate.
2. Describe any fines or penalties levied by government agencies during the past 10 years. (If none, so indicate)
3. Describe any pending litigation or current lawsuits which if adversely resolved would materially impact the financial position of the Applicant.
4. Attach:
|_| a. Personal Financial Statement documenting assets and liabilities.
|_| b. Credit Reports for the individual(s) from a major credit reporting company such as Equifax, Experian, and Dunn & Bradstreet.
NOTICES
PRIVACY ACT STATEMENT
Authority: Title 54, National Park Service and Related Programs; and the National Environmental Policy Act of 1969.
Purpose: The purpose of the system is to assist, monitor, track and issue leases to individuals and businesses for National Park Service structures and land for activities that are not subject to authorization through a concession contract, commercial use authorization, or similar instrument in federally owned or administered property located within the boundaries of park areas. A leased property must be used for an activity and in a manner that is consistent with the purposes established by law for the park and be compatible with the programs of the National Park Service.
Routine Uses: Records or information contained in this system is not disclosed outside of the Department of the Interior except for those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act; or other authorized routine use when the disclosure is compatible with the purpose for which the records were compiled.
Disclosure: Voluntary, however, failure to provide the requested information may impede our ability to issue a lease contract to the individual or organization.
PAPERWORK REDUCTION ACT STATEMENT
We collect this information under the authority of 54 U.S.C. 102101 et seq., 54 U.S.C. 306121, and 36 CFR part 18. We use this information to evaluate proposals received in response to leasing opportunities. Your response is required to obtain or retain a benefit. We may not collect or sponsor and you are not required to respond to a collection of information unless it displays a currently valid OMB control number. OMB has approved this collection of information and assigned Control No. 1024-0233.
ESTIMATED BURDEN STATEMENT
We estimate that it will take you 10 hours to complete a standard Request for Proposal, including 2 hours to complete this form, including time to review instructions, gather and maintain data, and complete and review the form. You may send comments on the burden estimate or any aspect of this form to the Information Collection Clearance Officer, National Park Service, 12201 Sunrise Valley Drive, Mail Stop 242, Reston, VA 20192. Please do not send your completed form to this address.
RECORDS RETENTION. TEMPORARY. Destroy/Delete 3 years after closure. (NPS Records Schedule, Commercial Visitor Services, (Item 5D) (N1-79-08-4)) image1.jpg image2.jpg
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